MICHIGAN DEPARTMENT OF ENVIRONMENTAL QUALITY - …



MICHIGAN DEPARTMENT OF ENVIRONMENT, GREAT LAKES, AND ENERGY – OIL, GAS, AND MINERALS DIVISION

ANNULAR PRESSURE TEST

| |Permit Number |

| |      |

| |Well name & No. |

| |      |

| |Surface location |

| |     1/4 of      1/4 of      1/4, Section      T      R       |

|Name and address of permittee |Township County |

|      |            |

|      | |

|      | |

|      | |

|      | |

| |Well type: Waste Disposal (Class I) Solution Mining (Class III) |

| | |

| |Spent Brine Return (Class V) Storage |

| |Natural Brine Production |

|Date of test |Casing size |Tubing size (if applicable) |

|      |      |      |

|Type of gauge |Packer type/model |Packer depth (feet) |

| |      |      |

|inch face      psi range       psi increments       | | |

|New gauge Yes No (if no, enter the date of test calibration)       |Top of Permitted Injection Zone (feet)       |

| | |

|Calibration Certification Submitted? Yes No | |

|Fluid return (gallons) |

|      |

|Purpose of Test and Test Results Test Results Requirements |

|(NOTE: The difference between the testing pressure and the tubing For Class III and Brine Production wells, readings must be taken at |

|pressure shall not be less than 100 psig at the time of the test). least every 10 minutes for a minimum of 30 minutes. For Class I, Class |

| |

|V, and Storage wells, readings must be taken every 10 minutes for 60 |

|5-year or annual test? Yes No minutes. Annulus test pressure shall not be less than 300 psig or |

|New permitted well? Yes No 100 psig above max. injection pressure. If test is unwitnessed, original After rework?|

|Yes No chart must be submitted. |

|Other? Yes No |

| |

| |PRESSURE READINGS |

|TIME |ANNULUS |TUBING |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

|      |      |      |

Test Pressures: For Disposal (Class I/Class V) & Storage Wells - Max. Allowable Pressure Change (3%): Initial Pressure x 0.03 psi =       psi

For Class III & Artificial/Natural Brine Prod. Wells - Max. Allowable Pressure Change (5%): Initial Pressure x 0.05 psi =       psi

Test Passed Test Failed Test Period Pressure Change       psi

NOTE: If test fails, the well must be shut-in, no injection can occur, and the EGLE-OGMD shall be notified within 24 hours. Corrective action may be needed and the well re-tested. An Authorization to Inject must be received before injection can commence.

|Was test witnessed by a EGLE-OGMD representative? Yes No If yes, name of EGLE-OGMD representative       |

|CERTIFICATION “I state that I am authorized by said owner. This report was prepared under my supervision and direction. The facts stated herein are true, accurate and |

|complete to the best of my knowledge.” |

| |

|      |

|Company Representative Date |

Mail original to the appropriate Oil, Gas, and Minerals Division District Office

EQP 7606MW (rev. 05/2019)

-----------------------

[pic]

By authority of Part 625 of

Act 451 PA 1994, as amended.

Non-submission and/or falsification of this information

may result in fines and/or imprisonment.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download